HomeMy WebLinkAboutFMC APP 1.29.19• , pi •
APPL.ICATIO
TO PERFORM ELD /LINE TESTING/
SB989 SECONDARY CONTAINMENT
TESTING /TANK TIGHTNESS TEST AND
FUEL MONITORING CERTIFICATION
(Please note that these are separate
individual tests and will be charged per
separate type test accordingly.)
PERMIT #
❑ ENHANCED LEAK DETECTION ❑ LINE TESTING
❑ TANK TIGHTNESS FUEL MONITORING CERTIFICATION
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
Bakersfield, CA 93301
Phone: 661 -326 -3979 • Fax: 661- 852 -2171
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❑ SB -989 SECONDARY CONTAINMENT
OVERFILL PREVENTION
FACILITY NAME & PHONE # OF CONTACT PERSON
Bakersfield Police Department Adan Cuevas (661) 326 -3887
ADDRESS
1601 Truxtun Avenue, Bakersfield, CA. 93309
OWNER NAME
City of Bakersfield
OPERATOR NAME PERMIT TO OPERATE #
Adan Cuevas
# OF TANKS TO BE TESTED: IS PIPING GOING TO BE TESTED? ❑ YES ❑ NO
TANK# VOLUME CONTENTS
1 15,000 Unleaded
TESTING COMPANY NAME & PHONE # OF CONTACT PERSON
Cal Valley Equipment Jerry Rangel 661 -615 -4076
MAILING ADDRESS
7608 Frultvale Avenue, Bakersfield, CA. 93308
NAME & PHONE # OF TESTER OR SPECIAL INSPECTOR CERTIFICATION #
Jerry Rangel 661 - 979 -0953 Veeder Root: B35460, OPW:0128241, Incon: 1037433709
TEST METHOD ICC #
Industry Standard 8160834
APPLICANT SIGNATURE DATE
'THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
APPROVED BY I DATE
FD2095 (Rev 03/18)